Etanercept (CPB 0315, reviewed 2026-07-08)
Aetna's Clinical Policy Bulletin 0315 considers etanercept (Enbrel) medically necessary for rheumatoid arthritis, articular juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, plaque psoriasis, reactive arthritis, hidradenitis suppurativa, graft versus host disease, Behcet's disease and immune checkpoint inhibitor-related toxicity when the listed criteria are met. Initial criteria differ by indication and include prior treatment with other drugs for several of them, and continuation of therapy requires a positive clinical response. Aetna considers all other indications experimental, investigational, or unproven, including concomitant use with another biologic or targeted synthetic drug for the same indication.